The Trump administration’s sudden firing of Centers for Disease Control and Prevention employees gutted training programs across the nation whose participants bolstered the workforce of state and local public health departments that for decades have been starved of resources.
The programs are designed to cultivate a new generation of public health leaders, many of whom have gone on to work at the CDC. That was far from its only purpose. Local and state officials said the departures threaten to undermine the nation’s constant effort to identify and control infectious disease outbreaks.
The terminated CDC employees helped prevent and respond to outbreaks such as dengue fever and the flu. They worked with local officials to quickly test for viruses and ensure that testing in public health labs complies with federal regulations. Others monitored potential cases of tuberculosis or provided health education to adolescents to prevent sexually transmitted infections, according to interviews with fired workers and local public health officials.
As a CDC public health adviser, Gaël Cruanes had been working at New York City’s Department of Health and Mental Hygiene to detect cases of tuberculosis, a serious illness that spreads through the air and usually attacks the lungs.
The Public Health Associate Program deploys recent college graduates and other early-career workers for two years. After starting his job in October, Cruanes said, he contacted newly arrived immigrants and refugees potentially at risk of spreading TB in hopes of getting them into the city’s clinics for screening.
“It’s purely for the safety of the public at the end of the day,” Cruanes said. He and other trainees were fired in mid-February.
“It’s unconscionable,” he said.
A spokesperson for the Department of Health and Human Services, Andrew Nixon, declined to comment. The White House and CDC didn’t respond to requests for comment.
The Trump administration’s swift staff reductions in February targeted probationary employees, many hired in the past two years, who lack civil service protections against firings. The administration on Feb. 26 ordered federal agencies to submit plans by mid-March for large-scale layoffs, a move that could encompass a much broader swath of workers.
Seven CDC employees — including from the associate program — assigned to the New York City health department were terminated, Michelle Morse, the agency’s acting commissioner, testified during a City Council hearing Feb. 19.
In an interview, Morse said the health department was exploring how to retain them.
“We’re looking into what the CDC could do,” she said, “but we are really just trying to use our own levers that we have within the health department to see what’s possible for those staff.”
Since its creation in 2007, the Public Health Associate Program has placed 1,800 people in nearly every state and territory, plus the District of Columbia, according to the CDC.
The sudden firings meant “there was no lead time to try to figure out what we’re going to do,” said Anissa Davis, the city health officer at the Long Beach Department of Health and Human Services in California.
Three participants of the associate program worked at the Long Beach department, Davis said. A CDC public health adviser was one of four employees working on sexually transmitted infections and HIV surveillance. Two others were with the 13-person communicable disease control team, which includes staff who respond to outbreaks in nursing homes, hospitals, restaurants, and schools, Davis said.
“They are invaluable,” Davis said. “Public health is always under-resourced so having these people really helps us.”
The U.S. public health system was already under severe strain at the onset of the covid-19 pandemic — tens of thousands of jobs disappeared after the 2007-09 recession hit, and spending also dropped significantly for state and local health departments, according to a KFF Health News investigation. The backlash against pandemic-era restrictions drove many more officials to resign or retire. Others were fired. Still, officials said the pandemic also inspired some to pursue public health careers.
Scientists in the CDC’s Laboratory Leadership Service program were also fired in February. The CDC in 2015 started the two-year training fellowship to improve lab safety and quality following a series of failures, including in 2014 when CDC staff in Atlanta were potentially exposed to anthrax. The program each year recruits a small number of doctorate-level scientists; several work in state or local health departments.
At least 16 of 24 fellows in the program were fired in mid-February, according to two scientists who were terminated and spoke on the condition of anonymity for fear of professional retaliation. “Now we can’t be a resource for these labs anymore,” one of them said.
Public health labs need the CDC scientists “because they’re underfunded, understaffed,” the other said. “They are at their capacity already.”
Lab fellows’ responsibilities included helping with outbreak investigations and responses, including by training local staff on how to safely run tests or analyzing samples to identify the cause of an illness. Fellows were recently involved in setting up a new test in Florida to detect Oropouche, a relatively unknown insect-borne disease that has no vaccine or effective treatment. The World Health Organization in December said more than 11,600 cases had been reported in 2024 in South America, the Caribbean, the U.S., Europe, Canada, and Panama. The Florida Department of Health didn’t respond to a request for comment.
Fellows also helped develop the capacity to test for dengue fever in American Samoa, one of them said.
“When new stuff happens that’s urgent, it’s almost all the time we get pivoted to it,” the person said.
Participants in different training programs received the same form letter notifying them of their terminations, according to documents viewed by KFF Health News.
The letters said that terminated people had shown poor performance: “Unfortunately, the Agency finds that you are not fit for continued employment because your ability, knowledge and skills do not fit the Agency’s current needs, and your performance has not been adequate to justify further employment at the Agency.”
However, the fellows’ supervisors had written memos and emails saying they were in good standing, according to documents viewed by KFF Health News. Cruanes said he had not had a performance evaluation when he was terminated — his first was supposed to be Feb. 18, three days after he received his notice.
In Minneapolis, a CDC public health adviser had been providing sexual and reproductive health education in two high schools, as well as doing citywide work on STI testing, said Barbara Kyle, the city’s school-based clinic manager. The department was trying to shift those responsibilities to remaining personnel. “We’re right now just scrambling,” she said.
The city has relied on trainees through the CDC program for more than a decade, Kyle said.
“These two years of learning public health, on-the-ground experience, has really been such a positive move for our country,” she said. “So that concerns me if we lose that pipeline.”
Healthbeat reporter Eliza Fawcett contributed to this report from New York City.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.